test 1

Question 1

what is tympanometric peak pressure and what is the normal range?

Answer 1

TPP (daPa): pressure at which the peak ccompliance is found
-100daPa to +50daPa

Question 2

what is equivalent ear can volume and what is the range?

Answer 2

VEC: the admittance when ear haas max positive pressure
0.6cm^3 to 2cm^3

Question 3

what is middle ear admittance or peeak compensated static acoustic admittance (or compliance) and what is the normal range?

Answer 3

Ytm (mmho): the peak admittance minus external ear admittance or the peak height on the compensated tymp
0.3mmho to 1.7mmho

Question 4

what is the tympogram width and the normal range?

Answer 4

it is the width of the tympanogram at 50% of the peak
51daPa to 114daPa

Question 5

what type of tymp is type A?

Answer 5

normal

Question 6

what type of tymp is type B?

Answer 6

flat tymp, no peak

Question 7

what is a type C tymp?

Answer 7

very negative pressure
- common when ppl are sick

Question 8

what is a type As tymp?

Answer 8

shallow tymp (abnormally stiff)

Question 9

what is a Ad tymp?

Answer 9

too deep (flaccid, too much movement)

Question 10

What types of tymp could you see in someone with Otitis Media with effusion?

Answer 10

Type As, C, and B
- C and B are more common
- might progress from C to B as it is healing before going back to normal

Question 11

What type of tymp would we see with Ossicular Discontinuity?

Answer 11

type Ad (would be more movement/flaccidity)

Question 12

what type of tymp would we see with tympanic perforation?

Answer 12

Type B (flat)
- air pressure leaking from TM so there would be no peak

Question 13

if the tymp probe becomes blocked with cerumen, what type of tympaanogram will we see?

Answer 13

type B (flat)

Question 14

How would you differentiate what is causing a type B tymp?

Answer 14

Use the volume measure!
- TM performation will have largest volume (highest on y-axis)
- Otitis media with effusion: volume is in normal range
- clogged probe tip will ave a very low volume because it’s like you are right up against a wal

Question 15

What type of tymps appear with otosclerosis?

Answer 15

A or As (depending on severity of stiffness)

Question 16

what type of tymp is expected with eustachian tube blockage?

Answer 16

type C
- negative pressure tymp

Question 17

acoustic reflexs tell us?

Answer 17

thee neural patahway function

Question 18

which parts of the neural pathway can be checked with reflexes

Answer 18

8th nerve (vestibulocochlear)
7th nerve (facial)
loweer brainstem
- can also tell us somee info about heearing loss

Question 19

what is a vestibular schwanoma?

Answer 19

tumor that forms and damages thee myelin sheath and thus interrupting the pathway

Question 20

what are 5 traits of Vestibular Schwannoma’s?

Answer 20

1. unilaterel 95% of time
2. slow growing (1-2mm) and benign (usually)
3. unuilateral high frequency hearing loss can occur
4. can grow out of the internal auditory meatus into CPA (cerbral space)
5. if the nerve gets damaged, reflex is affected

Question 21

what is the order of the reflex pathway ipsilaterally

Answer 21

ex: right side
- right cochlea
- 8th nerve
- ventral cochlear nucleas
- superior olivary complex
- facial nerve motor nucleus
- facial nerve
- right stapedius muscle

Question 22

acoustic reeflex is ___

Answer 22

bilateral

Question 23

explain the bilateral pathway of the acoustic reflex

Answer 23

right ear stimulated:
- right cochlea
- 8th nerve
- ventral cocchlear nucleus
- superior olivary complex
- goes to BOTH right and left facial nerve nuclei
- RIGHT and LEFT facial nerves
- RIGHT and LEFT stapedius muscles

Question 24

which ear gets labels when doing reflex testing?

Answer 24

the ear receiving the stimulus

Question 25

when doing reflex testing, how many dB would you go up to confirm the reflex is getting bigger in response?

Answer 25

5dB | if the test dB was already quite high, we wouldnt go up ## Footnote do this because contralateral ear will be 5db higher for low frequency

Question 26

what is deflection criterion?

Answer 26

0.02 the level that the reflex must reach to be significant

Question 27

reflex strength grows with dBHL

Answer 27

reflex response gets bigger when we increase the sound level

Question 28

how do reflex thresholds change if a person has hearing loss?

Answer 28

- for mild hearing loss, the reflex thresholds do not change - for severe heaaraing loss, we would expect the reflex to occur at a higher dBHL

Question 29

what are gelfand norms?

Answer 29

normative values that tell us what the reflex should be

Question 30

whta does it mean if acoustic reflex thresholds are below 10th percentile?

Answer 30

too low for hearing loss

Question 31

ex: if hearing threshol is 70dbHL and the reflex is happening very close to that threshold, what could this indicate?

Answer 31

pseudohyperacusis

Question 32

if reflex threshold is between the 10th and 90th percentile then they are ?

Answer 32

within norms

Question 33

if reflex thresholdss are above 90th percentile, what is this caalled and what would we expect?

Answer 33

elevated -- expect a neural problem

Question 34

if reflex thresholds are not there at the highest level tested, what is this called and what do we expect?

Answer 34

absent -- expect a neural problem

Question 35

if reflex threshold are absent or elevated, they are

Answer 35

abnormal -- expect a neural problem

Question 36

how does thee reflex testing actually work

Answer 36

probe measures the reflex the stimulus can come out of the probe to measaure the ipsilateral response, or the stimulus can be played from regulara earphone in other ear for contrlateral response

Question 37

if we have an 8th nerve (vestcoch) disorder, where do we expect an abnormal reflex?

Answer 37

the STIMULUS side will have an abnormal response - ex: right 8th nerve damage-- right ipsi and right contra are abnormal

Question 38

if we have an 7th nerve (facial) disorder, where do we expect an abnormal reflex?

Answer 38

the PROBE side has the abnormal reflex - ex: tumor on the right 7th CN, abnormal right ipsi and left contra - ipsi-contra pair

Question 39

if there is a brainstem tumor, how will reflex be affected?

Answer 39

contralateral reflexes will be affected, ipsilateral usually reserved -sometimes both contras and one ipsi, depending onn tumor location

Question 40

if you see that both contralateral reflexes are abnormal/absent, what does this indicate?

Answer 40

central nervous system problem/brainstem

Question 41

how are reflexes effected by cochlear loss?

Answer 41

- you need to overcome the loss (play stimulus louder) - does not count as elevated if the reflex response is within gelfand norms (because we know the elevtaed sound stim was needed to overcome the loss)

Question 42

how does conductive loss impact recording reflexes?

Answer 42

eliminates reflex on the contra side (measaure side) and elevataes reflex on stimulus side | very difficult, often impossible to record

Question 43

is it worth it to measure reflexes in someone with conductive loss?

Answer 43

no because the reflex wont be accurately indicative of the neural response because the conductive system isnt working

Question 44

what would reflexess look like in someeone with bilateral conductive loss

Answer 44

absent everywhere

Question 46

what is reflex decay?

Answer 46

when the reflex response does not last for thhe entirety of the 10s stimulus

Question 47

half-life time in reflex decay

Answer 47

if the amplitude of ddeflection decreases to 50% of its max before half of the stimulus time this is abnormal